Cancellation of electronic prescriptions

Cancellation of electronic prescriptions

Release 2 of the Electronic Prescription Service will support the cancellation of electronic prescriptions.

Any authorised individual within the organisation where the prescription was created can authorise the cancellation of an electronic prescription. Prescribers will automatically have the authority to cancel prescriptions issued by themselves or other prescribers in the practice. Other staff, for example, the practice manager or support staff within a GP surgery may also be granted this authority.

An electronic prescription can only be cancelled where it has not been pulled down to a local dispensing system.

If an electronic prescription has already been pulled down by a dispensing site, prescribers should use local arrangements to request that the prescription is not dispensed, for example, telephoning the dispensing site. The prescribing system will provide information to the prescriber on which dispensing site has pulled down the prescription, together with the site’s contact details.

Electronic prescriptions, that have not been pulled down to a local dispensing site, can be cancelled on an individual item basis without invalidating the whole prescription however, if all items on an electronic prescription are cancelled this will automatically cancel the whole prescription.

In cancelling a prescription, the prescribing system will prompt the user to provide a reason code, for example ‘prescribing error’, ‘change to medication treatment regimen’, ‘at the patient’s request’ or ‘at the pharmacist’s request’. If multiple items are being cancelled, the prescriber can choose to give different cancellation reasons for different items.

The prescriber should normally inform the patient that the electronic prescription has been cancelled however if the patient visits a pharmacy with a prescription token to collect a prescription that has been cancelled, when the barcode is scanned to pull down the cancelled prescription from the spine, a rejection message will be sent to the pharmacy to indicate that the prescription has been cancelled by the prescriber.

Note, the rejection message will not include the reason why the prescription has been cancelled. It is the responsibility of the prescriber to communicate this to the patient.

If the patient has nominated a pharmacy and the patient has not been given a prescription token, if one item on a multi-item electronic prescription has been cancelled, the pharmacy system will be able to retrieve the electronic prescription and it will indicate that one item has been cancelled along with the reason for cancellation. However, if all items on the nominated prescription have been cancelled and the patient has not been given a prescription token, the pharmacy system will not retrieve the cancelled prescription and the pharmacy will not be aware that the electronic prescription existed but has been cancelled.

Prescribers are being advised never to assume that a prescription has been cancelled unless a positive cancellation response has been received from the system. If a response is not received within 5 minutes the prescriber should assume that the prescription has not been cancelled and follow existing procedures.

Cancellation requests cannot themselves be cancelled so to reinstate a prescription, a new prescription must be generated by the prescriber using a new prescription ID. An NHS electronic prescription cannot be amended once sent to the spine. If amendment is required, the prescriber would need to cancel the prescription and then regenerate it in amended form.

News update: Intentions to change the EPS cancellation process

Update: In January 2016, we published details of NHS Digital’s intention to introduce an enhancement to improve the prescription cancellation process during February 2016. 

NHS Digital explain this feature has not been introduced and instead a new process is intended to be introduced in a future release, which will allow all dispensing information to be forwarded to prescribers. More details will follow closer to the time.


FAQs

Q. Can a dispensing site cancel a prescription?
A. No, only authorised individuals working within the organisation that issued the prescription can cancel the prescription.

Q. Can an electronic prescription be amended?
A. No. An electronic NHS prescription cannot be amended once sent to the spine. If amendment is required, the prescriber would need to cancel the prescription and then regenerate it in amended form.

Q. In EPS Release 2, will a prescriber be able to cancel a prescription that has already been dispensed by a pharmacist?
A. Release 2 of the Electronic Prescription Service will support the cancellation of electronic prescriptions. It will not be possible for a prescription to be electronically cancelled by a prescriber, where it has the following status:

  • “Prescription/item not cancelled as with dispenser”
  • “Prescription/item not cancelled as with dispenser (active)”
  • “Prescription/item was not cancelled – dispensed to patient”
  • “Prescription/item cancellation requested by another prescriber”
  • “Prescription/item expired”
  • “Prescription/item not found”
  • “Prescription/Item had already been cancelled”

Where a prescription cannot be electronically cancelled, a prescriber can follow manual processes, as now, and call the pharmacist to explain that there is a problem with the prescription. To facilitate this, the prescribing system will provide information to the prescriber on which dispensing site has retrieved the prescription. This is an advance on current processes where the GP may not know which pharmacy the patient has gone to.

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